Provider Demographics
NPI:1124746557
Name:GREAT HANDS DIVINE HOMECARE AGENCY LLC
Entity type:Organization
Organization Name:GREAT HANDS DIVINE HOMECARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:ADAH
Authorized Official - Last Name:OBAJE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-895-9673
Mailing Address - Street 1:116 GREENSBORO RD STE 101-A
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27260-3454
Mailing Address - Country:US
Mailing Address - Phone:336-895-9673
Mailing Address - Fax:
Practice Address - Street 1:116 GREENSBORO RD STE 101-A
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27260-3454
Practice Address - Country:US
Practice Address - Phone:336-895-9673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care